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Apthous ulcer

Aphthous ulcers are typically found inside the mouth, not on the genitals, though they can appear on the genitals in conditions like Behcet's disease.

Chancroid

The ulcer of chancroid is a painful, soft ulcer with a purulent base that is not preceded by a vesicular stage, unlike herpes.

EBV ulcer

Genital ulcers from EBV are rare and would be diagnosed by exclusion and specific viral testing in the absence of evidence for HSV.

Lymphogranuloma venereum

The primary lesion of LGV is a small, painless, transient papule or ulcer that often goes unnoticed, followed by dramatic, painful inguinal lymphadenopathy (buboes).

Syphilitic chancre

The classic primary chancre of syphilis is a single, painless ulcer with a clean base and a firm, indurated border, which is morphologically and symptomatically distinct from the multiple, painful, vesicular-then-ulcerative lesions of herpes.

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